Avp Revenue Cycle Ops - Denial Management (Remote West Coast)

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

This leader is directly responsible for providing leadership to the Denial Management division for acute and ambulatory claim denial prevention and cash acceleration. This position is critical to the success of Revenue Cycle Operations billing and collection performance to meet and exceed internal and external (client) goals.

In addition to the leadership of the operational area, this position will have significant interaction with prospective and current client leadership. This individual must provide collaboration with technology and solution design teams, while continuing to deliver solid results to our clients.

If you are located in California, Arizona or Nevada, you will have the flexibility to work remotely* as you take on some tough challenges. This position will require some travel.

Primary Responsibilities:

• Lead a team to deliver consistent improvements through data analysis, trending, deep dive root cause identification and solid project management and value reporting to reduce denials, write-offs, rework, and aging A/R
• Partner with Financial Operation RCM Team to deliver solid patient financial performance results to accelerate cash and eliminate lost revenue (write-offs) which includes evaluation of denial trends associated with scheduling, registration, financially securing accounts, claim generation, coding, billing, cash posting, Denial Management, and other similar functions per client agreements
• Strategic planning to deliver scalable, evolving, and preventable solutions to meet developing client demands with collaboration with supporting areas to develop long term standard Center of Excellence Avoidable Denial Team
• Building solid and collaborative relationships with client management leaders to ensure we are exceeding expectations and raising areas of concern proactively
• Effectively utilize tools and data to capture and continually improve client and patient satisfaction. Ensure leadership team is effectively monitoring and cascading this to the line level staff
• Leads by example; promotes teamwork by fostering a positive, transparent and focused working environment which achieves maximum results
• Collaborates with and seeks to influence leaders across the various functions to deliver effective outcomes, programs and service offerings to align with organizational goals and objectives

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 5+ years of demonstrated ability to analyze, trend, root cause and solution for avoidable denials (people, process, technology and data) by working directly with internal RCM operations, Technology and external Payers
• 5+ years in a leadership role overseeing a centralized business office and supporting multiple locations, clients, and/or teams while interfacing with enterprise level executives internally and externally with an ability to demonstrate detailed experience of end-to-end Revenue Cycle processes (from registration to zero balance) including workflows, technology solutions, automation, reporting, and payer processing and behaviors
• 5+ years in a leadership role analyzing data, identifying root cause, and solutioning to drive accurate claims submission and reduce denial volumes while accelerating cash
• Demonstrated proficiency with Microsoft Excel, Word, and PowerPoint as well as Revenue Cycle platforms for billing & collection to be able to manipulate large, complex denial data files
• Demonstrated ability to make strategic, operational, and administrative decisions in response to emerging conditions and environmental circumstances
• Demonstrated experience building and maintaining rapport and influence with clients
• Demonstrated experience in analyzing opportunities and develop creative solutions to a wide variety of unique implementation challenges
• Ability to inspire staff to work together toward common goals and develop solid employee engagement strategies
• Proven excellent communication, leadership, customer service, critical thinking, and problem-solving skills
• Ability to manage and support organizational change and assist individuals through the transition
• Capable of interpreting, communicating and executing organizational mission and value concepts to a wide range of organizational and community representatives
• Ability to travel up to 25%

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $122,100 to $234,700 annually. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment